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Tsai-Ling Liu, A Sidney Barritt Iv, Morris Weinberger, John E Paul, Bruce Fried, Justin G Trogdon
BACKGROUND: Increasingly, patients with multiple chronic conditions are being managed in patient-centered medical homes (PCMH) that coordinate primary and specialty care. However, little is known about the types of providers treating complex patients with diabetes and compensated cirrhosis. OBJECTIVE: We examined the mix of physician specialties who see patients dually-diagnosed with diabetes and compensated cirrhosis. DESIGN: Retrospective cross-sectional study using 2000-2013 MarketScan® Commercial Claims and Encounters and Medicare Supplemental Databases...
2016: PloS One
Koichi Nagata, Shungo Endo, Tetsuro Honda, Takaaki Yasuda, Michiaki Hirayama, Sho Takahashi, Takashi Kato, Shoichi Horita, Ken Furuya, Kenji Kasai, Hiroshi Matsumoto, Yoshiki Kimura, Kenichi Utano, Hideharu Sugimoto, Hiroyuki Kato, Rieko Yamada, Junta Yamamichi, Takeshi Shimamoto, Yasuji Ryu, Osamu Matsui, Hitoshi Kondo, Ayako Doi, Taro Abe, Hiro-O Yamano, Ken Takeuchi, Hiroyuki Hanai, Yukihisa Saida, Katsuyuki Fukuda, Janne Näppi, Hiroyuki Yoshida
OBJECTIVES: The objective of this study was to assess prospectively the diagnostic accuracy of computer-assisted computed tomographic colonography (CTC) in the detection of polypoid (pedunculated or sessile) and nonpolypoid neoplasms and compare the accuracy between gastroenterologists and radiologists. METHODS: This nationwide multicenter prospective controlled trial recruited 1,257 participants with average or high risk of colorectal cancer at 14 Japanese institutions...
October 25, 2016: American Journal of Gastroenterology
Anik Goulet, Raphael Lencucha
No abstract text is available yet for this article.
October 21, 2016: Digestive Diseases and Sciences
Dominique Ryan, Fiona Pelly, Elizabeth Purcell
BACKGROUND: Extending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system. Australia's health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative...
October 21, 2016: BMC Health Services Research
Kathryn F Flack, Jay Desai, Jennifer M Kolb, Prapti Chatterjee, Lars C Wallentin, Michael Ezekowitz, Salim Yusuf, Stuart Connolly, Paul Reilly, Martina Brueckmann, John Ilgenfritz, James Aisenberg
BACKGROUND & AIMS: Gastrointestinal (GI) bleeding in patients receiving anticoagulation agents can be caused by occult malignancies. We investigated the proportions and features of major GI bleeding (MGIB) events related to occult GI cancers in patients receiving anticoagulation therapy. METHODS: We analyzed data from the Randomized Evaluation of Long Term Anticoagulant Therapy study (conducted between December 2005 and March 2009 in 951 clinical centers in 44 countries worldwide), which compared the abilities of dabigatran vs warfarin to prevent stroke and systemic embolism in 18,113 patients with atrial fibrillation...
October 17, 2016: Clinical Gastroenterology and Hepatology
Paul R Tarnasky
Post-cholecystectomy syndrome and the concept of a causal relationship to sphincter of Oddi dysfunction, despite the controversy, has presented a clinically relevant conflict for decades. Historically surgeons, and now gastroenterologists have expended tremendous efforts towards trying to better understand the dilemma that is confounded by unique patient phenotypes. Areas Covered: This review encompasses the literature from a century of experience on the topic of post-cholecystectomy syndrome. Relevant historical and anecdotal experiences are examined in the setting of insights from evaluation of recently available controlled data...
October 20, 2016: Expert Review of Gastroenterology & Hepatology
David Graham, Gideon Lipman, Vinay Sehgal, Laurence B Lovat
The landscape for patients with Barrett's oesophagus (BE) has changed significantly in the last decade. Research and new guidelines have helped gastroenterologists to better identify those patients with BE who are particularly at risk of developing oesophageal adenocarcinoma. In parallel, developments in endoscopic image enhancement technology and optical biopsy techniques have improved our ability to detect high-risk lesions. Once these lesions have been identified, the improvements in minimally invasive endoscopic therapies has meant that these patients can potentially be cured of early cancer and high-risk dysplastic lesions without the need for surgery, which still has a significant morbidity and mortality...
October 2016: Frontline Gastroenterology
Jason Reich, Ling Guo, Julia Hall, Ashley Tran, Janice Weinberg, Jacob Groshek, Tanya E Rowell, Jack A DiPalma, Francis A Farraye
BACKGROUND: With the recent increase in the use of social media, patients with chronic illnesses are using the Internet as a resource for disease management. As the peak incidence of inflammatory bowel disease (IBD) occurs in patients between the ages of 15 and 30, IBD is a suitable condition to study social media use. The aim of this study was to assess social media usage and preferences in patients with IBD. METHODS: We administered a survey to 118 patients with IBD at our outpatient practice at the Boston Medical Center (BMC), Center for Digestive Disorders, and the University of Southern Alabama (USA) between November 1, 2015, and March 9, 2016...
November 2016: Inflammatory Bowel Diseases
Kimberly N Weaver, Michael D Kappelman, Robert S Sandler, Christopher F Martin, Wenli Chen, Kristen Anton, Millie D Long
BACKGROUND: As variation in care has previously been linked to quality, we aimed to describe variations in inflammatory bowel diseases care by gastroenterology (GI) practice setting. METHODS: We performed a cross-sectional study within the Crohn's and Colitis Foundation of America Partners and used bivariate analyses to compare patient characteristics by GI practice setting (GI-academic [GIA], GI-private, or GI-other). Regression models were used to describe the effects of provider type on steroid use, disease activity, and the quality of life...
November 2016: Inflammatory Bowel Diseases
Anthony Razzak, Dineen Smith, Maliha Zahid, Georgios Papachristou, Asif Khalid
Background and aims: Adenoma detection rate (ADR) and cecal withdrawal time (CWT) have been identified as measures of colonoscopy quality. This study evaluates the impact of monitoring these measures on provider performance. Methods: Six blinded gastroenterologists practicing at a Veterans Affairs Medical Center were prospectively monitored over 9 months. Data for screening, adenoma surveillance, and fecal occult blood test positive (FOBT +) indicated colonoscopies were obtained, including exam preparation quality, cecal intubation rate, CWT, ADR, adenomas per colonoscopy (APC), and adverse events...
October 2016: Endoscopy International Open
Antonio López-Serrano, Inmaculada Ortiz Polo, Javier Sanz de la Vega, Eduardo Moreno-Osset
Obesity is a highly prevalent disease worldwide, and one in which gastroenterologists can play an important role. Some digestive diseases are more common in obese patients, and preoperative evaluation may be required in some cases. Additionally, bariatric surgery can lead to digestive complications in the short and long term that require intervention, and endoscopic treatment can be an important factor in weight loss. The aim of this review is to highlight the role of the gastroenterologist in the management of obese patients who are either scheduled for or have undergone surgical or endoscopic treatment for obesity...
October 13, 2016: Gastroenterología y Hepatología
Poonam Verma, Surabhi Dayal, V K Jain, Ashish Amrani
Pegylated interferon α and ribavirin therapy is associated with increased incidence of various systemic and cutaneous side effects. Among the side effects of this therapy, alopecia universalis is a rarely reported side effect which causes significant cosmetic concern to the patient. We report a rare case of alopecia universalis which developed eight weeks after discontinuation of this antiviral combination therapy. This gains importance because it is essential to sensitize the treating gastroenterologist and the dermatologist regarding this rare side effect...
October 14, 2016: Journal of Chemotherapy
Anca Trifan, Oana Stoica, Catalin-Alexandru Chihaia, Mihai Danciu, Carol Stanciu, Ana-Maria Singeap
INTRODUCTION: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by a marked eosinophilic infiltrate in the esophageal mucosa. What was once considered a rare disease has nowadays become one of the most frequent esophageal diseases in the Western countries, occupying a place just next to the gastroesophageal reflux disease. EoE etiology and pathogenesis remain largely unknown, although most studies consider that allergic and genetic factors play the most important role...
October 2016: Medicine (Baltimore)
Chun Woo Lim, Min Hwan Park, Hyun Jeong Do, Jung-Sook Yeom, Ji Sook Park, Eun Sil Park, Ji Hyun Seo, Jung Je Park, Jae Young Lim, Chan Hoo Park, Hyang-Ok Woo, Hee-Shang Youn
PURPOSE: The management and clinical course in pediatric patients who had ingested foreign body were investigated retrospectively to evaluate the frequency and factor associated with successful removal of fishbone foreign body. METHODS: Based on the medical records of patients younger than 15 years old who visited emergency room because of foreign body ingestion from January 1999 to December 2012, the authors reviewed clinical characteristics including type of ingested foreign bodies, time to visits, managements and complications...
September 2016: Pediatric Gastroenterology, Hepatology & Nutrition
Neelam S Kumari, Shyamala Srujana, Annapoorna Sireesha, L Krishna, O Sharavan Kumar
Esophageal melanocytosis is a rare benign condition characterized by melanocytic proliferation in esophageal squamous epithelium and melanin deposition in the mucosa. Because of its uncommon nature, pathologists and gastroenterologists lack experience with this entity. We present a case of esophageal melanocytosis in a 66 years old male patient who presented with atypical chest pain and dysphagia. Endoscopic guided biopsy was done, provisional diagnosis of esophageal melanocytosis was made. Bleaching and immunohistochemistry confirmed the diagnosis...
May 2016: Journal of the Association of Physicians of India
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Vivian Wai-Mei Huang, Hsiu-Ju Chang, Karen Ivy Kroeker, Karen Jean Goodman, Kathleen M Hegadoren, Levinus Albert Dieleman, Richard Neil Fedorak
Background. Inflammatory bowel disease (IBD) affects patients in their young reproductive years. Women with IBD require maintenance therapies during pregnancy and breastfeeding. However, physician management of IBD during pregnancy and breastfeeding has not been well characterized. Objective. To characterize physician perceptions and management of IBD during pregnancy and breastfeeding. Methods. A cross-sectional survey of Canadian physicians who are involved in the care of women with IBD was conducted. The survey included multiple-choice and Likert scale questions about perceptions and practice patterns regarding the management of IBD during pregnancy and breastfeeding...
2016: Canadian Journal of Gastroenterology & Hepatology
Jean-Frédéric LeBlanc, Myriam Martel, Alan N Barkun
Introduction. Data are conflicting when assessing indications for colorectal self-expandable metallic stents (SEMS) in managing acute malignant large bowel obstruction (MLO). In November 2014, European and American Societies published guidelines to aid in understanding which patients might benefit from colorectal stenting. Yet, there remain marked disparities in clinical practice. Methods. A web-based survey was sent to Gastroenterologists and Surgical Specialists across Quebec to assess physicians' knowledge and adherence to the indications for colonic SEMS placement in the management of MLO using eight clinical scenarios...
2016: Canadian Journal of Gastroenterology & Hepatology
S Miehlke, R Loibl, S Meszaros, J Labenz
Purpose: The acceptance and realization of clinical guidelines in daily routine practice is unknown. The aim of this study was to evaluate the behaviour of private gastroenterologists in Germany with respect to the diagnostic and therapeutic management of H. pylori infection in times of increasing antibiotic resistance. Methods: Between 12/2014 and 02/2015 a standardized questionnaire with 19 multiple choice questions were sent to 1507 private gastroenterologists in Germany. The data were electronically captured and analyzed using SurveyMonkey...
October 2016: Zeitschrift Für Gastroenterologie
Rachel E Andrew, Evangelos Messaris
Acute severe ulcerative colitis (UC) is a highly morbid condition that requires both medical and surgical management through the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery...
September 27, 2016: World Journal of Gastrointestinal Surgery
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